STUDY OF LEFT ATRIAL ENLARGEMENT AND ITS CORRELATION WITH LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH SYSTEMIC HYPERTENSION

Sarthak Sharma; Sachin Agrawal; Rajesh Sarode; Sunil Kumar

Volume : VII, Issue : II, February - 2018

STUDY OF LEFT ATRIAL ENLARGEMENT AND ITS CORRELATION WITH LEFT VENTRICULAR HYPERTROPHY IN PATIENTS WITH SYSTEMIC HYPERTENSION

Sarthak Sharma, Sachin Agrawal, Rajesh Sarode, Sunil Kumar

Abstract :

Left ventricular hypertrophy has been suggested to mediate the relation between hypertension and left atrial enlargement. However, less is known about correlates of left atrial size in hypertensive patients with left ventricular hypertrophy. We assessed left atrial enlargement by echocardiography and electrocardiography in 500 hypertensive patients, age 25 years and above (mean, 58.65) and compared it with electrocardiographic and echocardiographic left ventricular hypertrophy at baseline. Enlarged left atrial diameter (women, 3.8 cm; men, 4.2 cm) was present in 46.4% of women and 53.5% of men (P <0.01) with mean left atrial volume index 33.84 (ml/m²) and 32.32(ml/m²) respectively. Compared with the 388 patients with normal left atrial size, the 112 patients with enlarged left atrium more often had echocardiographic left ventricular hypertrophy. They also had higher age, systolic blood pressure, pulse pressure, weight, body mass index and interventricular septal thickness (all, P <0.01). In logistic regression analysis, left atrial enlargement was related to left ventricular hypertrophy and eccentric geometry; greater body mass index, systolic blood pressure, and age and female gender (all, P<0.01). Thus, left atrial size in hypertensive patients with electrocardiographic left ventricular hypertrophy is influenced by gender, age, obesity, systolic blood pressure, and left ventricular geometry. Also ECG showed very low sensitivity but high specificity in detecting LAE as compared to ECHO which is the gold standard. Sensitivity and specificity of ECG for detecting LAE depends upon the number of diagnostic criteria taken into account. Sensitivity of ECG in detecting LAE can be increased by using more criteria.